Exam4- HIV disease Flashcards Preview

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Flashcards in Exam4- HIV disease Deck (33):
1

HIV patho

retrovirus
-changes itself to be inserted into the host and it can never be killed

2

What is HIV's genetic material?

RNA: single stranded ribonucleic acid

3

How is RNA converted in the HIV life cycle?

Reverse transcriptase (RT) is used to covert single stranded RNA into double stranded DNA

4

Role of intergrade enzyme in the HIV life cycle

Integrase enzyme allows the viral double stranded DNA to be inserted into the double stranded DNA of the host

5

HIV Life Cycle

1. Attachment and fusion
2. Injection of core
3. Uncoating
4. Conversion to DNA
5. Circular DNA
6. Entrance into nucleus
7. Integration
8. Transcription
9. Translation
10.Protein modification
11.Assembly of core
12. Budding

6

Effects of HIV

# 0f CD4+ T-cells patient has, whether any opportunistic infections have occurred, indicates difference

Immune system can attack & destroy early on; 3 of HIV particles overwhelms system over time

7

HIV s/s

-acute infection develops within 1st month after infection
-night sweats, chills, headaches, muscle aches, rash,, sore throat

-symptoms fade & patient feels better (some may not look into the symptoms due to them leaving so fast)

8

Stage 1

confirmed HIV infection
CD4-T call count >500 cells mm3

9

Stage 2

Confirmed HIV infection
CD4 T-cell count b/w 200-499 cells mm3

10

Stage 3

confirmed HIV infection
CD4 T-cell count <200 cells mm3 or > 200 with a documented AIDS defining illness (ex. pneumocystis pneumonia)

11

Stage 4

Confirmed HIV infection
No other information regarding CD4 cell counts or AIDS defining illness
*Not worse, just don't know the answer to the questions*

12

Long-term nonpregressors (LTNPs)

genetic mutation does cause a resistance to the virus entering the host cells. HIV positive for greater than 10 years & without symptoms

13

Health Promotion

Educate best hope for prevention

14

3 ways HIV usually transmitted

sexual
parenteral
perinatal

15

ABCs

A- abstinence
B-be faithful to one partner
C- use condoms

16

Transmission Health care workers

needle stick injuries
exposure to non intact skin/mucous membranes to blood and body fluids

STANDARD PRECAUTIONS ARE BEST PREVENTION!!!

17

Management

Assessment - ask questions
Hx
Physical Assessment/clinical manifestations: Infections, Malignancies, Endocrine complications

18

Manifestations: Infections

opportunistic, protozoal, fungal, bacterial, viral

19

Manifestations: Malignancies

Kaposi's scarcoma, malignant lymphomas

20

Manifestations: Endocrine complications

Gonadal dysfunction
Body shape changes
Adrenal insufficiency

21

Manifestations: AIDS dementia complex

occurs in 70% of those with AIDS
Varies in severity

22

Manifestations: AIDS wasting syndrome

altered metabolism
GI dysfunction

23

Manifestations: Skin changes

dry, itchy irritated skin

24

viral load

amount of virus present in blood/other body fluids

should be less than 50 if they are taken regularly
more likely t transmit with high viral load

25

Higher Blood levels of HIV (viremia)

greater risk for sexual/perinatal transmission

26

Lymphocyte count

WBC <3500 cells/mm3

27

CD4+ T-cells & CD8+ T-cells

ratio normally is 2:1
normal CD4 is 500-1500
AIDS can be fewer than 100

28

Antibody tests

ELISA: early testing can result in false negative
Western blot, viral load: more accurate, more expensive, used to confirm presence of HIV

29

Quantitative RNE assays

used to monitor therapy

30

Home test kits

dont want family to know
may be more difficult to get insurance with HIV
Needs confirmation by blood test

31

HAART: Highly Active Antiretroviral Therapy

NRTIs: Zidovudine
NNRTIs: Delavirdine
Pis: Atazanavir
Fusion inhibitors: enfuvirtide
Entry inhibitors: Maraviroc
Integrase inhibitors: Raltegrase

cART= combination antiretroviral therapy (new name)

32

Safe Sex Practices

Latex or polyurethane condoms
Latex gloves
Dental Dams
New research- vaginal gel with antiretroviral agent

33

Priority patient problems

potential for infection
inadequate oxygenation
pain
inadequate nutrition
diarrhea
reduced skin integrity
confession
reduced self-esteem
potential loss of social contact